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During evaluation of peripheral lymphocytosis (absolute lymphocytosis >4,000/µL), the possibility of a malignant disorder requires evaluation.
Tests generally appear in the order most useful for common clinical situations
| Test name: Leukemia/Lymphoma Phenotyping (Comprehensive - Whole Blood) |
| ARUP #: 0096299 |
| Methodology: Flow Cytometry |
| Use: Use for whole blood specimens; aids in selection of appropriate therapy and assessment of clinical behavior and prognosis Available antigens included: |
| Test name: Leukemia/Lymphoma Phenotyping (Comprehensive - Bone Marrow) |
| ARUP #: 0095244 |
| Methodology: Flow Cytometry |
| Use: Use for bone marrow specimens to aid in selection of appropriate therapy and assessment of clinical behavior and prognosis Available antigens included: |
| Test name: Leukemia/Lymphoma Phenotyping (Comprehensive - Miscellaneous) |
| ARUP #: 0095243 |
| Methodology: Flow Cytometry |
| Use: Use for tissue specimens or fluids to aid in selection of appropriate therapy and assessment of clinical behavior and prognosis Available antigens included: |
| Test name: T-Cell Clonality by Flow Cytometry Analysis of TCR V-Beta |
| ARUP #: 0093199 |
| Methodology: Flow Cytometry |
| Use: Further characterize phenotypically abnormal T-cell populations identified by flow cytometry Determine the existence of monoclonality based on expression of TCR beta chain variable regions |
| Limitations: Tests only for TCR alpha-beta receptors; if identification of TCR gamma-delta receptors is desired, PCR testing is recommended |
| Test name: T-Cell Clonality Screening Assay by PCR, Fluid |
| ARUP #: 0055567 |
| Methodology: Polymerase Chain Reaction/Fragment Analysis |
| Use: Determine presence of monoclonal T-cell population in whole blood or bone marrow |
| Limitations: "Not detected" result does not entirely exclude the presence of a TCRgamma rearrangement (or monoclonal T-cell population) in the sample |
| Follow-up: A PCR screen result of "Not detected" PCR screening results should be terminally analyzed by restriction fragment Southern blot hybridization to definitively exclude T-cell monoclonality (not automatically performed unless otherwise stipulated) |
| Test name: T-Cell Clonality Screening Assay by PCR, Tissue |
| ARUP #: 0055568 |
| Methodology: Polymerase Chain Reaction/Fragment Analysis |
| Use: Determine presence of a monoclonal T-cell population in tissue |
| Limitations: A result of "Not detected" does not entirely exclude the presence of a TCR gamma gene rearrangement (or monoclonal T-cell population) in the sample |
| Follow-up: A PCR screen result of "Not detected" should be terminally analyzed by restriction fragment Southern blot hybridization to definitively exclude T-cell monoclonality (not automatically performed unless otherwise stipulated) |
| Test name: T-Cell Clonality Assessment by Restriction Fragment-Southern Blot Hybridization, Tissue |
| ARUP #: 0055594 |
| Methodology: Restriction Fragment Southern Blot Hybridization |
| Use: Confirm presence of TCR beta gene arrangement presence in tissue |
| Limitations: Negative result does not entirely exclude the presence of a TCR gene rearrangement (or monoclonal T-cell population) in the sample |
| Test name: T-Cell Clonality Assessment by Restriction Fragment-Southern Blot Hybridization, Fluid |
| ARUP #: 0055596 |
| Methodology: Restriction Fragment Southern Blot Hybridization |
| Use: Confirm presence of TCR beta gene arrangement presence in whole blood or bone marrow |
| Limitations: Negative result does not entirely exclude the presence of a TCR gene rearrangement (or monoclonal T-cell population) in the sample |
| Test name: IGH-BCL2 (BCL-2/JH) Translocation, t(14;18) by PCR, Fluid |
| ARUP #: 0055616 |
| Methodology: Polymerase Chain Reaction |
| Use: Detect chromosomal translocation t(14:18) (BCL2/IGH gene rearrangements) [bcl-2/JH] Components include BCL2-IGH, t(14;18) [bcl-2/JH] translocation major breakpoint and minor cluster regions |
| Limitations: Negative result does not entirely exclude the presence of a BCL2-IGH [bcl-2/JH] chromosomal t(14;18) translocation |
| Test name: IGH-BCL2 (BCL-2/JH) Translocation, t(14;18) by PCR, Tissue |
| ARUP #: 0055619 |
| Methodology: Polymerase Chain Reaction |
| Use: Determine presence of BCL2-IGH, t(14;18) [bcl-2/JH] chromosomal translocation (non-Hodgkin lymphoma) Components include BCL2-IGH, t(14;18) [bcl-2/JH] translocation major breakpoint and minor cluster region |
| Limitations: Negative result does not entirely exclude the presence of a BCL2-IGH [bcl-2/JH] chromosomal t(14;18) translocation |
| Test name: IGH-BCL2 Fusion, t(14;18) by FISH |
| ARUP #: 2001536 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Determine presence of BCL2-IGH, t(14;18) [bcl-2/JH] chromosomal translocation (NHL) in fixed tissue (paraffin embedded tissues) |
| Test name: IGH-MYC Fusion t(8;14) by FISH |
| ARUP #: 2001538 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Determine presence of MYC translocations in BL and other NHL in fixed tissues (paraffin embedded tissues) |
| Test name: Lymphoma (Aggressive) Panel by FISH |
| ARUP #: 2002650 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Identification of dual-hit and triple-hit lymphomas Provides prognostic information for B-cell lymphomas with features intermediate between DLBCL and BL FISH probes include MYC, BCL6, and IGH-BCL2 |
| Limitations: Fresh tissue sample required Detects only the specific aberrations in chromosomes of interest for diagnosis and prognosis; alterations outside regions complementary to these probes will not be detected |
| Test name: Chromosome FISH, Interphase |
| ARUP #: 2002298 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Detect chromosome abnormalities associated with lymphoma FISH probes must be specified and include MYC (c-Myc) rearrangements, t(11;14) (IGH-CCND1), t(14;18) (IGH-BCL2), IGH rearrangement with unknown partner, ALK rearrangements, and BCL6 rearrangements Indicate names of probes needed for testing ARUP Oncology FISH Probes menu |
| Limitations: Fresh tissue sample required |
| Test name: IgVH Mutation Analysis by Sequencing |
| ARUP #: 0040227 |
| Methodology: Polymerase Chain Reaction/Sequencing |
| Use: Assist in the clinical management of patients with established diagnosis of CLL |
| Limitations: Assay is designed for use with a confirmed diagnosis of CLL and includes sequencing Use of this assay for all other diagnoses will terminate after amplification and will not include sequencing |
| Test name: ZAP-70 Analysis by Flow Cytometry |
| ARUP #: 0092392 |
| Methodology: Flow Cytometry |
| Use: Assist in the clinical management of patients with established diagnosis of CLL |
| Limitations: Results should not be used for diagnostic purposes and should always be correlated with morphologic and clinical information |
| Test name: Chromosome FISH, CLL Panel |
| ARUP #: 2002295 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Assist in prognosis of CLL Specific genomic abnormalities tested for are: ATM deletion, 13q deletion, p53 deletion, and trisomy 12 |
| Limitations: Limit of detection is probe dependent and ~1-5% in interphase nuclei |
| Follow-up: Repeat testing as clinically indicated to monitor disease progression |
| Test name: Chromosome Analysis, Bone Marrow |
| ARUP #: 2002292 |
| Methodology: Giemsa-Band Analysis |
| Use: Detect chromosome abnormalities associated with lymphoproliferative disorders in bone marrow |
| Follow-up: Repeat testing as clinically indicated to monitor disease progression |
| Test name: IGH-CCND1 Fusion, t(11;14) by FISH |
| ARUP #: 0049381 |
| Methodology: Fluorescence in situ Hybridization |
| Use: Assist in the clinical management of patients with established diagnoses of mantle cell lymphoma Fixed tissue sample required |
| Test name: IGH-CCND1 (BCL-1/JH) Translocation, t(11;14) by PCR, Fluid |
| ARUP #: 0055557 |
| Methodology: Polymerase Chain Reaction |
| Use: Assist in the clinical management of patients with established diagnoses of mantle cell lymphoma Detect CCND1-IGH, t(11,14) [bcl-1/JH] translocation |
| Limitations: Negative result does not entirely exclude the presence of a CCND1-IGH [bcl-1/JH] chromosomal t(11;14) translocation |
| Test name: Immunohistochemistry Stain Offering |
| ARUP #: |
| Methodology: |
| Use: Recommended stains for lymphoma phenotyping are available on the following ARUP Consult topics:
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